Thickness of the Plantar Fascia in Asymptomatic Subjects.

OBJECTIVES: The objectives of this study are to determine the average and extreme values of the thickness of plantar fascia (PF) and to evaluate its correlations with anthropometric parameters and walking activity. MATERIALS AND METHODS: Analytic study of 226 feet. On these feet, the thickness of the PF was measured on ultrasound; and its correlation with the age, height, weight, body mass index (BMI), gender, and daily walking of the participants were studied. RESULTS: Thickness of the PF was symmetrical; the extreme values were 1.8 mm and 4.3 mm with an average of 3 mm ± 0.5. There was positive correlation of PF thickness with age, height, weight, BMI, and daily walking (P < 0.05). The variation of the PF thickness with gender was not significant (P > 0.05). CONCLUSION: Thickness of PF has a close correlates with age, height, weight, BMI, and walking activity.

Outcome of patients with uterine fibroids after 3-month ulipristal acetate therapy.

OBJECTIVES: To determine the proportion and the characteristics of patients who did or did not respond after 3 months of ulipristal acetate (UPA) therapy. STUDY DESIGN: In this retrospective cohort study conducted in the University Hospital of Bordeaux (France) and University Medical Center Ljubljana (Slovenia), symptomatic non-menopausal patients with fibroids that qualified for surgery were pretreated by 3 months of oral UPA 5 mg/day. Clinical success was defined by normalization of the bleeding score, and/or regression of pelvic pain, and/or abdominal distension. Imaging success was defined by reduction in fibroid volume ≥ 25%. RESULTS: The clinical and imaging success rates were 54/66 (82%) and 39/66 (59%) respectively. The absence of previous pregnancy (p = 0.004) and the size of the dominant fibroid ≥ 80 mm (p = 0.004) were independent factors associated with clinical failure. Age <35 years (p = 0.02) was the only independent factor associated with imaging failure. CONCLUSION: Young women developing fibroids and/or women with large fibroids may be resistant to ulipristal acetate therapy.

[Renal dimensions in the Nephrology Department of Befelatanana Hospital, Antananarivo]. / Dimensions rénales en Service de Néphrologie Clinique, Befelatanana, Antananarivo.

The knowledge of normale renal sizes specific for each individual and for any ethnicity, allows diagnostic and therapeutic medical decision. For a low-income country such as Madagascar, ultrasound is an ideal tool for this purpose. This study aims to collect data on renal dimensions and to seek the correlation between these data and the demographic and anthropometric parameters in Malagasies. This is a retrospective study of 200 non-diabetic patients without chronic kidney disease, spanning 3 years, conducted in the Nephrology Department of Befelatanana Hospital, Antananarivo. The average age of our patients was 45 ±16 years, with a sex-ratio of 0,9. On average, the dimensions (length x width x thickness) were 98 mm × 42 mm × 30 mm for right kidney, 99 mm × 45 mm × 31 mm for the left kidney. We found a significant difference between the right and left kidney in length (p<0.00001) and width (p = 0.03). A significant relationship was also found between renal length and age (p = 0.0016 and p = 0.04 respectively for the right kidney and the left kidney). No significant relationship was found between renal dimensions and size and patients weight. Despite its limitations, our study would provide important supports for clinical practice as well as for further studies.

[Hemodynamic and respiratory conditions of patients with obstetric fistulae operated under spinal anesthesia at the Regional Reference Hospital in Manakara, Madagascar]. / Etats hémodynamiques et respiratoires des opérées de fistules obstétricales sous rachianesthésie au CHRR Manakara, Madagascar.

The objective was to evaluate the hemodynamic and respiratory conditions of patients who had undergone obstetric fistula surgery and to report our experience in the management of these patients. We conducted a descriptive cross-sectional study in the Operating Room and Intensive Care Unit of the Regional Reference Hospital in Manakara from 20 to 30 August 2013. All patients who had undergone obstetric fistula surgery under spinal anesthesia were included in the study. We excluded patients classified as ASA> 2 and those with cardiovascular or respiratory disorders. After pre-anesthetic consultation and preoperative assessments, patients received bupivacaine 12.5 mg with adrenaline 0,5% isobar intrathecal. They were placed in the Trendelenburg position for 5 minutes after the injection of anesthesia and during surgery. Intraoperative sensory level, blood pressure, heart rate, respiratory rate and peripheral capillary oxygen saturation (SpO2) were recorded. 57 patients were retained. The sensory and motor block were excellent in all patients. A metameric level higher than T6 was achieved in 56.36% of patients. Despite a few episodes of hypertension and tachycardia, no patient had respiratory or cardiovascular problems associated with Trendelenburg position. Only sensory level and respiratory rate showed a correlation with Trendelenburg position (p=0,01). This study suggests that Trendelenburg position can be used during spinal anesthesia if an appropriate anesthetic is administered, paying particular attention to changes in position and taking into account the pre-anesthetic examination.